Kirkwood Hospice

Updated 1 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 09 September 2016 and was unannounced. The inspection was conducted by two adult social care inspectors, a pharmacy inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The area of expertise of the expert by experience on this inspection was as a family carer. Prior to our inspection we reviewed all the information we held about the service. This included information from notifications received from the registered provider, and feedback from the local authority safeguarding team, the clinical commissioning group and Health Watch. The provider had returned a ‘Provider Information Return’ (PIR) form prior to the inspection. This form enables the provider to submit in advance information about their service to inform the inspection.

We used a number of different methods to help us understand the experiences of people who used the service. We spent time observing the support people received and the environment. We spoke with five people who used the service and six of their relatives or friends. We also spoke with two doctors, two care workers, three nurses, one social worker, the premises and support coordinator, a physiotherapist, a cook, the registered manager and the deputy manager. During our inspection we spent time looking at four people’s care and support records. We also looked at three records relating to staff recruitment, training records, maintenance records, and a selection of the service’s audits.

Updated 1 February 2017

This inspection took place on 7 September 2016 and was unannounced. The service was last inspected on 26 November 2013 and at that time the service was meeting all the regulations we inspected.

Kirkwood Hospice provides treatment for people who have advanced, progressive life-threatening illnesses such as cancer, neurological diseases, advanced heart and lung disease and end stage kidney failure. They provided ‘in-patient care,’ for up to 16 people. People are admitted to the in-patient unit for symptom control and medicine reviews and to support people and their families with their illness and treatment plans. The average length of stay at the hospice was seven days. There were 11 people using the in-patient hospice beds at the time of this inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People we spoke with told us they felt safe at Kirkwood Hospice.

Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse. The provider had safe recruitment and selection procedures in place.

There were enough staff to meet people’s needs in a timely manner and medicines were managed in a safe way for people.

Staff had received an induction, supervision, appraisal and specialist training to enable them to provide support to the people who used the service. An effective overview of staff training and supervision was in the process of being developed to ensure staff were up to date with their training and development needs.

Staff were supported to maintain their professional registration where appropriate, reflect on and improve practice and share learning and expertise to support with the local community.

People’s consent to care and treatment was sought in line with legislation and guidance.

Meals were planned on an individual basis and people could choose from an all-day menu. People’s dietary requirements were catered for and people told us catering staff went the extra mile to meet their individual preferences.

A multidisciplinary team of healthcare professionals was available on site and effective liaison was evident between community professionals and the staff team.

The environment was clean and comfortable. It was also very well designed and maintained to accommodate people’s individual needs and promote their well-being.

People who used the service told us all the staff were excellent, showed compassion and went the extra mile to involve them in decision making and to support them with their end of life wishes.

We saw staff were caring and supported people in a way that maintained their dignity, privacy and human rights. People gave us examples of how they had been supported with compassion and sensitivity.

Staff were passionate about enabling people to experience a comfortable, dignified and pain free death. We saw the service provided holistic support, which included the persons family and support network.

People were supported to be as independent as possible and people’s cultural and religious needs were central to service provision.

People told us they were involved in their care planning and we saw they received personalised care that was regularly reviewed.

People were able to make choices about their care. Care plans detailed the care and support people required. From talking with people who used the service, their relatives and staff we were confident person-centred care was being delivered. Although some care records lacked information about personal goals a new project was being implemented to address this.

A range of activities were provided for people. Friends and family were welcomed to the service at any time.

Comments and complaints people made were responded to appropriately and any learning was reflected upon and implemented.

People using the service and their relatives told us they were very happy with the service.

The culture of the organisation was open and transparent and the registered manager was visible in the service.

People who used the service, their relatives, and staff were asked for their views about the service and they were acted upon.

The registered manager had a range of effective audits and quality assurance measures in place and was in the process of improving oversight of staff training and supervision.

The registered provider had an overview of the service and the board of trustees received regular reports to enable them to monitor and improve the quality and safety of the service.